经门静脉或肝动脉脐带血干细胞移植治疗失代偿期肝硬化的近期疗效与安全性比较  

Short-term efficacy and safety of umbilical cord blood stem cells transplantation through portal vain or hepatic artery for patients with decompensated cirrhosis

作　　者：王方[1] 冯淑娴[2] 寇俊峰[1] 云升皓[1] 蔡国芳[1] 王可敬[1] 杨兴坤[1] 

机构地区：[1]兰州军区总医院安宁分院感染病科,兰州市730070 [2]兰州军区总医院安宁分院妇产科

出　　处：《实用肝脏病杂志》2013年第4期327-329,共3页Journal of Practical Hepatology

摘　　要：目的比较经门静脉和肝动脉移植脐带血干细胞治疗失代偿期肝硬化患者的疗效与安全性。方法失代偿期肝硬化患者60例被随机分为门静脉治疗组30例和肝动脉治疗组30例。在基础治疗基础上,经皮经肝门静脉穿刺或经股动脉穿刺至肝固有动脉,注入相同数量的脐带血干细胞。观察两组患者临床症状改善情况及术后不良反应;治疗后8周检测血清ALT、AST、总胆红素、凝血酶原活动度和白蛋白水平。结果两组治疗后第3天全部患者乏力、纳差症状均改善,且两组间均未发现严重的不良反应及并发症;移植治疗后8周,门脉组和肝动脉组血清白蛋白分别升高至36.4±7.8g/L和37.1±9.1g/L,PTA分别上升至57.2±11.8%和55.6±12.5%,而ALT、AST、TBIL、AFP在门脉组分别为46.2±14.6IU/L、53.6±15.4IU/L、30.1±12.0μmol/L、13.2±2.8μg/L,在肝动脉组分别为48.2±10.8IU/L、50.2±13.8IU/L、32.1±10.2μmol/L、16.0±3.0μg/L,两组间观察指标在基线水平、变化值和观察终点水平差异均无显著意义。结论经门静脉和肝动脉移植脐带血干细胞治疗失代偿期肝硬化患者有一定的疗效,且安全可行,两种移植治疗近期疗效无显著性差异。Objective To determine and compare the short-term efficacy and safety of umbilical cord blood stem cells transplantation through portal vain or hepatic artery in patients with decompensated cirrhosis. Methods Sixty de-compensated cirrhotic patients were injected with umbilical cord blood stem cells via portal vein （portal vein group,n=30）or hepatic artery （hepatic artery group,n=30）. The improvement in clinical symptoms and adverse events were observed. Changes in serum levels of AST,ALT,total bilirubin,prothrombin activity,albumin and al-pha fetoprotein after 8 weeks of cell transplantation were determined. Results No differences in the improvement of clinical symptoms such as fatigue and poor appetite were found between the two groups,nor were in adverse events. After 8 weeks of transplantation,the serum albumin increased to 36.4±7.8g/L in portal vein group and 37.1± 9.1g/L in hepatic artery group. The prothrombin time activity increased to 57.2±11.8% and 55.6±12.5%,respec-tively. However,ALT,AST,total bilirubin and alpha fetoprotein decreased to 46.2±14.6IU/L,53.6±15.4 IU/L,30.1± 12.0μmol/L,13.2 ±2.8μg/L in portal vein group respectively,and to 48.2 ±10.8IU/L,50.2 ±13.8 IU/L,32.1 ±10.2μmol/L, 16.0 ±3.0μg/L in hepatic artery group respectively. Conclusion Injection of umbilical cord blood stem cells through portal vein or hepatic artery might have similar efficacy and safety in decompensated cirrhotic patients.

关 键 词：肝硬化 脐带血干细胞 移植 门静脉 肝动脉 

分 类 号：R575.2[医药卫生—消化系统]